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Safety in use of electrocoagulation in general surgical procedures in patients with an implanted pacemaker

Session Poster session 1

Speaker Associate Professor Daniil Maximkin

Congress : EHRA 2017

  • Topic : arrhythmias and device therapy
  • Sub-topic : Antibradycardia Pacing
  • Session type : Poster Session
  • FP Number : P425

Authors : A Faibushevich (Moscow,RU), V Baranovich (Moscow,RU), D A Maximkin (Moscow,RU), G Veretnik (Moscow,RU), E Gitelzon (Moscow,RU), N Safonov (Moscow,RU)

A Faibushevich1 , V Baranovich1 , D A Maximkin1 , G Veretnik1 , E Gitelzon1 , N Safonov1 , 1RUDN University - Moscow - Russian Federation ,

Europace ( 2017 ) 19 ( Supplement 3 ), iii91

Patients with implanted pacemakers are 1-2% among patients admitted for emergency and planned surgeries on abdominal and chest organs, peripheral vessels, musculoskeletal system. The presence of the pacemaker in the patient confronts the surgeon and anesthesiologist a number of issues related to the risk of serious violations of the pacemaker, up to the complete failure of the pacemaker during the surgery. The aim of this study is to write the algorithm for the safe use of electrocoagulation during general surgical procedures in patients with an implanted pacemaker.
Methods: the study included two phases. Phase I: a retrospective analysis of surgical treatment of 986 patients whom permanent pacemakers were implanted in Central Clinical Hospital . The analysis of the data showed that among them 123 patients had a various surgeries after pacemaker implantation. Period before pacemaker implantation after general surgical procedures was from 7 days to 12 years. There were 75 (61%) men and 48 (39%) women. The age of patients ranged from 27 to 80 years (mean age 68.3 ± 1.7 years). At this phase we created recommendation of the surgical procedures for patients with implanted pacemakers. Recommendation includes: a comprehensive survey of the pacemaker system, the increase in the stimulating pulse amplitude, reprogramming pacemaker in bipolar mode and use of electrocoagulation in bipolar mode. II-d and main phase of the study included 92 patients with previously implanted pacemakers who had the planned procedures at the Department of Hospital Surgery with the course of Pediatric Surgery. Sex distribution among the patients: 60 men and 32 women (65.2 and 34.8%, respectively). The mean age was 67.2 ± 2.3 years. All procedures were performed with the mandatory application developed recommendations. There were no pacemaker errors during surgery and in the postoperative period.
Conclusion. Permanent pacemakers in patients are not a contraindication for surgery, including cardiac surgery - coronary artery bypass grafting and valvuloplasty. Using modern pacemaker models while meeting the safety measures and the use of bipolar electrocoagulation allows doctors to perform surgeries of any complexity using electrocoagulation without the risk of pacemaker errors.

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